Changing Minds, Saving Lives through Breast Cancer Research

October, Breast Cancer Awareness Month, reminds women that this cancer is one of the top two cancer killers of women of all races and ethnicities in the U.S. But for a group of nurse researchers at the Johns Hopkins University School of Nursing (JHUSON) and clinical nurses at the Johns Hopkins Hospital (JHH) Avon Foundation Breast Center, breast cancer is a central concern of every month. Working in laboratories and clinics in communities around the corner and around the world, they’re battling for women’s lives every day.

Reaching Out to Improve Breast Cancer Awareness, Engagement—Regular screening mammograms—as recommended by the American Cancer Society—are known to be effective in reducing breast cancer deaths, but many women don’t get screened regularly or at all, particularly Asian American women. They are among the least likely to get a mammogram compared to women of all other racial and ethnic groups. JHUSON associate professor Haera Han, PhD, RN, and nursing doctoral candidate JingJing Shang, MSN, RN, OCN, are working to change those statistics. Both are pushing back against growing rates of breast cancer among Korean American and Chinese American women and breaking new ground in community-based, participatory research to identify and overcome barriers to breast cancer screening for these women.

Han’s research has disclosed that the Korean American community does not widely use preventive health services like mammograms. One-third of women in her study had never heard of a mammogram. The reasons: cultural beliefs that emphasize urgent care, not preventive care; fatalism; limited English; a dauntingly complex health care system; and a lack of health insurance. Han notes, “With long work days without weekend or holiday breaks, a lack of health insurance, and limited English skills, mammograms simply aren’t a high priority.” To help change that equation, her National Institutes of Health-supported work is developing and testing tailored health messages to help Korean American women understand the benefits of breast cancer screening. Han says, “Our message, based in the traditional Korean role of the woman as a family’s center, is simple: ‘Take care of yourself; if your health suffers, your family suffers, too’. And women are starting to hear and heed the message.” Her broader goal is to build health literacy skills that can give Korean American women the skills needed to negotiate the health system, to communicate with their health care providers, and to understand that prevention and screening work.

In one of the first studies of its kind, Shang, who lost a family member to breast cancer, has found similar reasons underlying the reluctance among Chinese American women to be screened for breast cancer: cultural and language barriers, discomfort with the Western medicine, cost and fear, among others. Her goal now is to design and test specific ways to motivate older Chinese American women to get screened for breast cancer, beginning in Philadelphia’s Chinatown. Shang says, “Preventive health care, like breast screening, helps women gain control over their environment in a way they may never have experienced. And in helping to achieve that change, we can demonstrate for all women that prevention works and that screening can save lives.”